Much Can Happen In A Year
by Fics by Stacey
Summary: Our favorite medical team encounters more fun, misadventure, and wild chaos at Sacred Heart while building up relationships and gaining new friendships over the course of one long and glorious year.
1. I Hate Goodbyes And The Emergency Room

"_Over the last year I've noticed a strange pattern. Every so often a patient will come in needing our help, but on the flipside, will end up helping us in one way or another, whether it be by offering an open ear to talk to, relationship advice, or general encouragement, and even in the most stressful situations I can take the time to really appreciate these select few people . . ."_

"J.D …"

_"Take Ms. Mitchell for example. She's been in and out of the hospital for two months, and after her first two hours here at Sacred Heart everyone was babbling on and on about her, and how nice and insightful she was . . ."_

"J.D …"

"_Even though I've become friends with Ms. Mitchell, I tried to close myself off in the beginning. I thought to myself, "nope, I'm not getting close to this one," because getting close to a patient is like being in a relationship with someone who you know for a fact will break up with you later on. Yeah, whether it's through the front doors of the hospital, or passage into the afterlife – if you believe in such things – patients will leave no matter what, and it hurts every time."_

"J.D!"

"Carla!" JD snapped, half playfully but also in genuine frustration, "I completed my rounds, spoke with Dr. Kelso about Mr. Webber's insurance fraud that poor Ted has to deal with now, had a five minute standoff with the Janitor which ended with me having to rinse Scrubbing Bubbles out of my hair, and changed Mr. Morris' catheter for Dr. Cox in less than a half hour, so to say the least, I need a little inner monologue time. Can it wait for five minutes?" _"I was almost proud of myself – I sounded like Dr. Cox except not nearly as mean or degrading."_

"Ms. Mitchell is checking out."

"_This is exactly why I try not to build friendships with patients anymore."_

Carla's announcement stung JD's heart like a bee, and not the kind Dr. Kelso enjoyed imitating the buzzing of. No, an angry bee, and with every passing second he felt it weighing heavier on him like a continuous flow of venom. He hoped that it wouldn't cause his emotions to swell, but could only assume that it would. It always did with people like Ms. Mitchell. He made his way down to the first floor tp see her off, rushing at times out of desire to get it over with, but going peculiarly slow at others, afraid of the emotional turmoil that was to come. After a long walk he rounded the corner and stepped into the lobby. When he saw Ms. Mitchell standing tall next to the front door he couldn't help but let a sad smile creep across his thick lips.

"Way to go, Ms. Mitchell, you're healthy again!" J.D praised as he came closer to her. "How dare that nasty pneumonia try to keep you down."

"I showed that ailment who's boss, didn't I?"

"You did!"

Though he spoke with enthusiasm, he was growing terribly sad, and it showed in a small falter of his voice. "You know, you showed me a lot too . . ."

"Oh, Dr. Dorian," Ms. Mitchell sighed, waving her right hand as if to dismiss his words, "I showed you how to make chicken pesto pasta; that doesn't deserve an encomium."

"I know but . . . wait, an econo what?"

She laughed. "An encomium. It's a formal expression of high praise."

"But you do deserve that!" J.D exclaimed. "I feel like after every conversation you and I have I'm a better, smarter person."

"I'm an old woman," she began, cooing almost as if J.D was a baby, which he didn't mind. "I have a lot of wisdom and experience, and it's only the right thing to pass it all on to youngsters like you."

There was a short pause.

"Dr. Dorian, it's been an honor, and thank you again for everything you've done to help me get better."

"You're welcome. It's the least I could do for someone like you."

There was another short pause, and then J.D spoke up once more. "What are you looking forward to getting back to most?" He asked curiously. Ms. Mitchell was a busy woman, and seemed to always be doing something exciting.

"Going back to school and being with my students." She replied proudly. "I've been to many places, but Northern University is my home."

"Well, I hope you have a great time there. Take care of yourself."

"You too, Dr. Dorian."

Then came the hard part – walking away. J.D turned around and hastily made his way out of the lobby, yet even in the midst of his haste it still felt like slow motion to him. _"When you say goodbye to someone who has inspired you for a while, you almost feel like a bird trying to fly for the first time, but then when you look back . . ."_

J.D turned around and looked to where Ms. Mitchell stood. All he could see was the outside door closing. The woman nowhere in sight. _". . . it's like the mother bird was never even there."_ With that, he lifted his chin and pressed onward._ "I tried not to let it get to me. After all, I still had people – my friends, and the other mother bird; the stricter, more terrifying, and sometimes downright cold mother bird . . ."_

"Newbie!" Dr. Cox barked.

"_Ahh, there's the sweet chirp now!"_

"Yes mother bir– I mean, Dr. Cox?"

Dr. Cox's brow furrowed in an angry-like look of confusion at J.D. "I'm not even going to begin to ask what you came close to calling me there, but I need you to cover the nightshift for Dr. Henderson."

J.D's face was instantly wiped clean of all expression, yet in his eyes Dr. Cox could see much aggravation. "Can you handle that, Monica?"

Every fiber of J.D's being wanted to say no. He was looking forward to having a night off after working all but one day that week, yet he knew that he couldn't refuse. Reluctantly and forcing a cheesy smile, he nodded his head. "I can handle that."

"Aww, don't feel so bad, Moni." Dr. Cox began sarcastically. "All you have to do is tend to your patients, Dr. Henderson's patients, who for the most part need almost constant care, while assisting me in the emergency room all night, which really shouldn't be that bad. I mean, it's just Friday, so we'll only have to deal with victims of senseless violence, drunkards, druggies, car accidents, stupid teenagers who have nothing to do but hurt themselves and make our lives that much more complicated. Really, it won't be all that terrible." He cringed. "Ugh, who am I kidding, I'm getting sweaty palms just thinking about it."

"At least you don't have the butterflies yet."

"Now don't you start worrying that pretty little face of yours, too. Your entire little posse will be here with you, so you can all pull yourselves through this purgatory of a night to come in the most annoying of ways possible like you always do. Now come with me, I've got charts for you."

* * *

The butterflies J.D felt fluttering around in his gut seemed to be going to waste as the night was perhaps the quietest of Friday nights the hospital had seen in months. Even the emergency room maintained a reasonably low level of commotion. J.D's patients were all asleep, Dr. Henderson's patients were all asleep, and his pager hadn't gone off in nearly an hour, so he decided to check in with Turk and Carla and see how they were doing.

"I just wanna go home, baby." Turk groaned tiredly, burying his face in Carla's shoulder.

"Yeah? Well, so do the people who are gonna come in here needing surgery. I'm sure they'd rather be home on the couch watching TV than going under the knife." Carla paused and softly caressed the back of Turk's bald head, lightening her tone of voice. "But I want to go home too."

J.D cut in. "Right about now I'd be visiting Ms. Mitchell. I'd understand her advice more easily at night for some reason."

"I'm happier that she's gone." Turk said, only to receive bewildered (and almost offended) looks from his wife and best friend. "I mean, she's gone which means she's healthy. Isn't that what we were going for?"

"I guess so . . ."

J.D felt a wave of vibrations shake his hip which could only mean one thing – Dr. Cox needed help. Carla was paged as well, so together they zipped down to the ER. It was still abnormally quiet, but there was definitely a situation brewing. Two ambulances had just arrived. Dr. Cox was near the doorway walking alongside a stretcher, on which was a man who was clearly panicking, and his right hand was grotesquely swollen and mangled. Two of his fingers were dislocated, and a large cut stretching from his palm to the top of his wrist leaked much blood, but he didn't appear to be in immediate danger.

"Newbie, I need you to get him into a room and assess him, like now, now, now."

Without a word, J.D rushed over and placed his hands on the stretcher, failing to notice that Dr. Cox was gesturing in the opposite direction. With that he attempted to roll it forward, but Dr. Cox gave resistance. "Not him, you idiot!" He barked. He then pointed over to the right where there was another stretcher that J.D hadn't even seen yet. On this one was another fellow, this one much smaller in stature, and clearly in much more need. J.D hustled over to his side. A closer view made J.D's heart sink. This one was nothing more than a kid, and overall looked as though he was already dead . . . or soon to be. J.D placed two fingers on the side of the boy's blood-covered neck. He felt a small murmur that he wouldn't even consider to be a literal pulse. This kid needed help. Nervousness flooded into J.D's system, and to make matters worse, the man who Dr. Cox was tending to started to cry frantically.

"I didn't cause it! I didn't cause it!" he repeated through tears.

"Car accident?" J.D asked.

"More like a vehicular massacre," Dr. Cox replied, "and this one's drunk. So that kids' blood is gonna be on his hands unless we, meaning you, can do something to keep him alive, so get a move on it!"

"I didn't cause it! It wasn't my fault!" the man continued to wail. "I swear, I didn't do anything wrong!"

* * *

_"To be a doctor, you need to be able to withstand the most gruesome of sights. It used to be that whenever I saw something gross, like a grade school classmate vomiting on the playground or a shot of mid-surgery while channel surfing on the TV, I would gag and cry. Although I can now meet this need, I still feel terrible, physically and emotionally when I see anyone hurt or sick."_

J.D further inspected the boy and his many injuries. His forehead was split open from the tip of his left eyebrow to the tip of his right, and it was a deep wound. His eyes were shut, but his lids were swollen and taking on a light purple tint. Small pieces of glass were shimmering under the ceiling light – the problem was that they were embedded in his skin along the right side of his face from his temple to his lips which had a slash running diagonally through the left side. As he continued to inspect, J.D tried to assume what had happened to the boy in the accident.

"The driver-side window shattered . . ." he mumbled upon seeing the glass.

The boy's nose was crooked, was also turning purple, and blood was pouring from either nostril. The general misshapenness of his nose caused J.D to wonder if he could even breathe through it.

"He was thrown forward, but the airbag should've kept him in better shape than this."

"Maybe it didn't deploy fast enough, or at all." Carla added.

Carla tried to open the boy's mouth but there was too much blood to see anything. "Bambi, suction please!" She ordered.

While J.D worked, Carla gently places her hands on the sides of the boy's neck. She could feel internal swelling, leading her to believe that his airways were constricted, soon to be shut off entirely. She swept a finger along the outer front of his throat where the swelling was worse. Even upon applying pressure she could not feel his Adam's apple. A red flag went up.

"Oh goodness, we need airway access ASAP." She said. "Hurry, we're losing our window. If we don't get through it now he's a goner. J.D, did you get that suction?"

"I'm trying, but there's blood coming up his throat."

"Oh god, Dr. Cox!"

The elapsed time at this point was only twenty-five seconds, and already J.D, Carla, and everyone else in the room were feeling exhausted, relying on adrenaline alone to keep them functioning, but ultimately to keep the boy alive.

"What is it?" Dr. Cox asked, clearly displeased about being called in.

"We need your help gaining control of his airway – there's too much blood coming up into his throat. I think his neck might be broken."

"I'll bet money on it. Someone get me a ventilator."

...

Nothing happened and no one said a word. Cox whistled loudly. "I said a ventilator!"

"There isn't one in here!" one of the assisting doctors exclaimed.

J.D watched in fright as Dr. Cox's face turned from its normal complexion to a fiery red. He gritted his teeth as his bushy brow furrowed. It was the sheer essence of frustration seen on a man's face. "I'll deal with whoever did not stock this room with a ventilator later, but if you don't find me one in the next sixty seconds then you'll be the one to call the time of death, now go! Carla, bag him."

"There's too much blood in his throat!" J.D opposed. "If you bag him the air pressure will just push it down into his organs."

"Newbie, if he's not drowning now he'll be suffocating soon if we don't do something. Whatever blood we force in we'll get out. If we can keep him alive long enough we'll get him right up to surgery, but we're climbing this case one stair at a time so we gotta get past this one before we can proceed. Carla, bag him."

J.D stepped aside and took a deep breath, trying to clear his mind for a brief moment. One of the many things he disliked about the emergency room is that five minutes could pass and leave you feeling more tired and weary than an entire nightshift. This was a perfect example of the madness of the emergency room.


	2. He Fell Through The Loophole

Carla quickly put a bagged oxygen mask over the boy's mouth and proceeded to breath for him. Meanwhile, J.D finished inspecting his injuries. His torso was bruised. J.D gently pushed on his abdomen. He was alarmed by what he felt – softness, almost like a socket underneath his right lung. Dr. Cox calmly watched his young colleague. "What do you feel, Newbie?" he asked in a softer tone, having cooled down a little.

"Internal bleeding." J.D replied hesitantly.

Putting all of the injuries together – the large cut on his head, the broken nose, the broken neck, internal bleeding, in addition to a broken left leg, J.D sighed as if in defeat. "I really don't this kid can survive . . ." he thought out loud. No sooner had J.D finished speaking did the heart monitor beside the table change from a regulated series of beeps to one high-pitched, continuous ring. Everyone paused and looked over at the screen in horror. The boy had flat lined.

"C'mon!" J.D shouted. "Just because I said I didn't think you can survive doesn't mean you actually have to die!"

"Shut up!" Dr. Cox ordered.

He hastily stepped to the doorway and poked his head out. "I need that ventilator, now!" Turning back to the medical team, Dr. Cox clapped his hands as if to get them all together. "Charge the paddles, and someone please get a brace on his neck."

Dr. Cox watched the heart monitor for a change but there was none. He then grabbed the paddles, placing one on the boy's chest and the other on his side. He and Carla exchanged looks, telling the other that they were ready.

"Clear!"

As the machine whistled to a climax, J.D closed his eyes tight. He always hated to see the procedure. To him it was the worst form of electrocution to witness following the electric chair itself. It wasn't so much the feeling that bothered J.D, though he had been shocked before, but because of his own stupidity (and partly Turk's), but because it was painful to watch. To see someone on the brink of death and their body to convulse so violently for hope of a sign of life was heartbreaking. And the sound . . . the sound it made was gut wrenching. J.D felt his own stomach churn upon hearing the shock itself and again when the boy's lifeless body fall back to the table. Carla quickly put the mask back onto the boy's face and forced two breaths. Nothing changed.

"Clear!"

The horrendous thwack was heard again, causing J.D to flinch a little. Nothing changed, and hope was beginning to fade away from everyone.

"Clear!"

The third time was a charm – the boy's heart started to beat. Though faint, it was a beat nonetheless, leaving the team with no time to celebrate, but another chance to save him.

"Alright, his blood pressure is still dropping. Get a blood sample and find out what his type is. In the meantime get a bag of AB+ running. If we can get him and keep him stable then we'll be able to get him up to surgery, but to do that we've gotta get some blood in him, and would someone _please_ get a ventilator in him?" Dr. Cox started to leave the room.

"Where are you going?" Carla called after him.

"Carla, please. I can't do as much as the six of you can to save this kid. You've been around here for years, same for you, Newbie, so quit depending and start working. The only one doing any depending in here is him," he said, nodding down at the kid, "so are you gonna let him down? I'll leave the decision up to you."

"_Dr. Cox was definitely in a teaching phase. Whenever things get tough with a patient he'll come in and help, but won't see it all the way through. I can't tell if it's because he just doesn't want to be around to watch someone die, if he really was too busy to stick around, or if he actually trusted us enough to give us room to learn and practice. A part of myself doesn't even believe that I'm a very trustworthy doctor yet. A perfect example; while everyone else was working on much more complex things, like gaining access to the boy's bloody airway, I was busy plucking the little pieces of glass out of his face. The discouraging thing was that I was assigned to do that which made me wonder . . . did the other doctors not trust me either?"_

"_The boy survived long enough to make it to surgery. I walked alongside him as they wheeled him into the operating room, but I stopped there and turned around. Even now I don't know if he's still alive, but Turk is in charge, so I'm feeling hopeful."_

J.D made his way to hospice to see Elliot. Of course she did not work in that department, but a patient she had drawn close to was spending the remainder of her life there. She was an elderly woman with Alzheimer's disease. Hospice doubted she would live to see the next weekend. J.D rounded the corner and saw Elliot's figure standing just outside of a doorway. The moonlight coming in from a nearby window lined her shape like a bright essence of something good, and yet darkness overpowered, and a sense of sorrow and grief loomed over her. J.D could see it even from behind. He stopped when he was about ten feet behind her and looked beyond into the room. A woman's lifeless body laid on the bed, with three people on either side, all crying, and one holding the deceased's hand up to her tear-streaked cheek. Elliot's patient – her friend – had died. Very slowly, J.D approached her and gently took her by the arm, leading her further out into the hallway. "You okay?" he asked.

"I'm fine," Elliot replied, pushing a lose strand of her long, golden hair out of her face. But her voice was weak, and even in the dark J.D could see that her eyes were red as a result of tears that had already been shed. "You know, I'm just waiting around to see if the family needs anything."

"Isn't that what the hospice worker is supposed to do?"

Elliot didn't respond. Instead, her lower lip began to quiver. J.D hummed a sound of sympathy for his friend, and comfortingly put an arm around her shoulder, pulling her close and stroking her arm. Elliot inhaled sharply, clearly trying hard not to burst out crying.

"I hate hospitals." she spoke softly, resting her head on J.D's chest.

"No you don't. You work too good to hate it here."

Elliot sniffled. "What do you mean?" she took a step back and looked up at him.

"I watch you." J.D replied. "Not in a creepy stalker way of course, but I observe how you go about taking care of people here. It's like all of your patients are adopted into your family, and you care for them like they're your own sisters or brothers . . . or third cousins."

Elliot smiled, which assured J.D that he was doing something right to improve her mood. He decided to continue. "Seriously, I want to know what you do be so good with your patients."

She nodded her head, turned slightly, and began to slowly walk down the hallway, resisting the urge to look back into the room where she formerly stood. J.D followed closely.

"Well, first you have to stop referring to them as patients as much as you do. This was actually the first thing Carla ever told me about connecting with people here, is that you have to acknowledge their individuality. Gosh, I can't remember the last time I called Mrs. Jones a patient. I just always called her . . . Mrs. Jones." Elliot paused and collected her thoughts, not wanting to think about her friend who had died less than thirty minutes earlier. "And you can't be afraid to get to know them, or to let them get to know you. If you hold back, they'll be nothing more than a sick body to you. But if anything remotely close to a friendship forms, well, then you've got yourself a connection."

"Does that help you to take better care of them?" J.D asked.

"More than anything else." Elliot turned to face J.D. "I know how hard you tried to keep yourself from drawing close to Ms. Mitchell, but doesn't that make you feel like you never had what could have been? As far as a friendship goes, I mean."

J.D shrugged. "I guess I do." He shrugged again, this time with a sigh. "I can think back to a few times when I wanted to contribute more to our talks, and maybe ask a question or two."

"And now you have a void to fill."

That was all too familiar to the both of them. Locked away were their feelings and thoughts regarding each other, and the relationship that could have been. In fact, it was in the back of each of their minds, but they'd never tell.

* * *

Four hours later, J.D received word that the young boy came out of surgery alive, and immediately went to go see him. His skin was grimly pale; his cheeks lacking even the smallest hint of color. It was almost scary for J.D to see his complexion alone. His eyes were sunken in with exhaustion, and his eyelids were an even darker shade of purple than when J.D had last seen him. A machine breathed for him, and a monitor kept everyone aware of his heart rate and blood pressure – both of which were weak and low, yet stable. J.D sighed, leaning against the inside of the doorway and rubbing his bare chin. Elliot's words had really been insightful to him, and for some reason, he was wanting to put them into practice. He looked at the boy and tried to imagine him as someone he had known for a long time. Not quite a family member, but a friend at best. This sparked a small sense of compassion, but nothing more than what J.D normally felt.

What else did Elliot say…? J.D tried to remember. Then suddenly, it hit him. Individuality.

J.D brought himself to acknowledge that the boy was his own person – with his own friends, relatives, interests, strengths, weaknesses, identity . . . _identity!_

Without a moment to spare, J.D rushed off to find Dr. Cox, who was still working busily on the first floor. He found the man bending over a clipboard, reviewing the medical history of another patien… person.

"Dr. Cox." J.D said as he approached, all seriousness in his tone of voice. "Did we ever find out who the car accident kid was?"

Dr. Cox's lips moved into his typical half smile, half frown look. His brow raised a little, and he even let out the smallest hint of a scoff. But it was all because he was stalling. Moments after his expression changed – confusion and dismay written all over it. He shook his head and scoffed once more, but this time in a disgusted/angry manner. "You know what, we never even bothered to learn his name, and no one's come to visit him. As far as I know, no one has even been alerted that he's here. We don't know anything about what insurance coverage he has . . ."

He suddenly realized how ridiculous his words were. Here was a prime example of a small and unfortunate loophole, that somehow the boy had managed to slip right through. Annoyed, and deep in thought, Dr. Cox placed his head on the back of his head and took a deep breath. "Looks like we got ourselves another John Doe."

J.D rolled his eyes. He hated cases like these. They were such a hassle to handle, but he tried not to think of the boy as such. Just the fact that at the moment he had absolutely no known identity. This meant that if something happened, and for some reason his condition went downhill and the boy died, then none of his peers and loved ones would know. Not for a while at least, which certainly wouldn't go over well.

"Listen, I'm swamped for the rest of the night," Dr. Cox began, "can you at least try to find out something about him? His name, age, favorite animal . . . anything?"

"Yeah, I can do that." He replied with a nod of his head, reflecting on what Elliot had told him.

"Well get on it. Somewhere someone knows this kid and needs to know what's happened. Start with the police and work from there."


End file.
